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The NHS cannot continue its Bear Grylls style survival mission

Edmund Stubbs, 12 May 2016

The NHS is the Bear Grylls of healthcare systems around the world. As with the insect eating survival guru, no matter how far into crises it is plunged, until now, the system has always managed to survive, by pulling one trick after another out of the bag or by securing yet more government money to keep its show on the road.

But would it not be better for the NHS to instead become the Ray Mears of global health systems? This rival television presenter takes a different approach to survival, merrily making a lightly seasoned rabbit stew around a crackling fire in the middle of the wilderness instead of sucking moisture from the moss of a bare cliff face after a rough night’s sleep inside an animal carcass (a famous feat of Grylls).

The difference between the two survivalists’ approaches is the level of preparation they afford themselves before an expedition. Mears plans ahead, packing plenty of provisions and carefully mapping his route. Grylls, by contrast, prefers to jump out of a helicopter in some remote region of the world and react to the situation he then finds himself in; reveling in risk taking and enduring much hardship on his journey back to safety.

Such a strategy of reactive haphazard decision-making is uncannily reminiscent of the muddle-through approach of too many of our current NHS services. The British health system is continuously trying to cope with immense pressures from many different arenas. It has little time or resources left over for preparation or planning for the future.

Universal healthcare systems are typical of most high and middle income countries around the world; that is a system which pools the risk of ill health over the entire population (whether by a tax-based system or social insurance fund). This then pays all, or at least the majority of costs when we become ill, protecting us from bankruptcy and ensuring most treatments are accessible.

However, as our population ages, with more people having multiple, chronic diseases, which are hugely expensive to treat, we see our UK health system groaning under the pressures of winter A&E crises, demotivated staff, horror stories of care failures, missed waiting times and targets, to name a few. It is evident we must take action if we are to avert the demise of universal healthcare in the UK. For this reason, at Civitas, we wanted to see if agreement on how to preserve universal healthcare for the future could be reached.

‘If you were able to restructure British healthcare in any way you wished, how should it be changed?’ This is the question we asked 11 prominent health professionals, a group which included academics, NHS managers, clinicians, patient representatives, business leaders and a former health secretary. We wanted to discover what our 11 health experts would do if they had the time and means to design a perfect health system, and were able to keep, discard or alter anything they liked from the present structure. What would these imaginary blueprints for the future be? We believed that a consensus of opinion from a mix of authors with such a wide range of ideological backgrounds could present a realistic way forward.

However, rather to our surprise was the consistency with which each author placed an emphasis on the pre-clinical, social and behavioural aspects of health. There were repeated calls for investment in preventative medicine, modification of individuals’ behaviours and for civil society at large, especially the charitable sector, to become more involved in healthcare decisions.

The collection of opinions entitled ‘The Health of the Nation: Averting the demise of universal healthcare’ delivered a clear, collaborative message: altering British health services in yet more ways can never ensure the survival of universal healthcare in the UK. The only way we can guarantee the continuation of comprehensive, free, healthcare services is to leave the NHS be, and work outside the organisation, encouraging individuals to alter their lifestyles and society as a whole to priortise health issues in all its key policy areas. This would reduce the crippling demand from so many ill people for medical services.

The UK’s unhealthy population means the landscape surrounding the NHS is a treacherous one. It is dangerous for patients and soul-destroying for staff when the NHS has to fight for its own survival week in, week out. We need to start planning ahead, mapping out exactly where we are going and deciding what we will need. Addressing the health of the nation will allow us to take back control of our medical environment, not just survive within it, allowing free universal healthcare in Britain to survive against all the odds.

Edmund Stubbs is Civitas’ Healthcare Researcher

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